Document 0435
 DOCN  M9480435
 TI    Diagnosis of intracranial lymphoma in patients with AIDS: value of 201TI
       single-photon emission computed tomography.
 DT    9410
 AU    O'Malley JP; Ziessman HA; Kumar PN; Harkness BA; Tall JG; Pierce PF;
       Department of Radiology, Georgetown University Hospital,; Washington, DC
       20007.
 SO    AJR Am J Roentgenol. 1994 Aug;163(2):417-21. Unique Identifier :
       AIDSLINE MED/94311132
 AB    OBJECTIVE. Although the prevalence of intracranial lymphoma is high
       among patients with AIDS, current imaging techniques are not reliable
       for differentiating this tumor from other common nonneoplastic lesions,
       such as those seen in toxoplasmosis. The purpose of this study was to
       prospectively investigate the use of 201Tl single-photon emission
       computed tomography (SPECT) in identifying intracranial lymphoma in
       patients with AIDS. SUBJECTS AND METHODS. Thirteen patients with AIDS
       and intracranial masses underwent 201Tl imaging with a three-headed
       SPECT camera. Sic of the 13 were subsequently proved to have lymphoma.
       Studies were interpreted prospectively as showing tumor if uptake of
       201Tl was increased in the region where the lesion was seen on MR
       images. A lesion-to-nonlesion uptake ratio (counts/pixel) was calculated
       retrospectively. RESULTS. The SPECT images of six patients were
       interpreted prospectively as showing no lymphoma. Uptake ratios in these
       six patients were 0.77-1.95 (mean, 1.45). In each, tumor was excluded as
       a final diagnosis (four had toxoplasmosis, one had progressive
       multifocal leukoencephalopathy, and one had venous angioma). Among the
       seven patients with SPECT images interpreted as showing lymphoma, six
       were later proved to have lymphoma (uptake ratio: mean, 3.65; range,
       2.95-4.30; p < .005). The SPECT findings in the seventh patient were
       classified as false-positive for tumor on the basis of the prospective
       interpretation of the images; three concurrent infections were found at
       autopsy. The uptake ratio in this patient was low (1.81), suggesting
       that quantification might have diagnostic usefulness for improving
       accuracy. CONCLUSION. This preliminary study indicates that 201Tl SPECT
       might be a useful, noninvasive method for differentiating intracranial
       lymphoma from nonneoplastic lesions in patients with AIDS.
 DE    Adult  AIDS-Related Opportunistic Infections/RADIONUCLIDE IMAGING
       Brain/PATHOLOGY/RADIONUCLIDE IMAGING  Brain
       Neoplasms/DIAGNOSIS/EPIDEMIOLOGY/*RADIONUCLIDE IMAGING  Diagnosis,
       Differential  Female  Human  Lymphoma,
       AIDS-Related/DIAGNOSIS/EPIDEMIOLOGY/*RADIONUCLIDE  IMAGING  Magnetic
       Resonance Imaging  Male  Prospective Studies  Retrospective Studies
       Thallium Radioisotopes/DIAGNOSTIC USE  Tomography, Emission-Computed,
       Single-Photon  Toxoplasmosis, Cerebral/RADIONUCLIDE IMAGING  JOURNAL
       ARTICLE

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